Bleuler Four As — MRCPsych Paper B MCQ

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EasySchizophrenia & PsychosisBleuler Four AsMRCPsych Paper B

Which psychiatrist introduced the term schizophrenia and is conventionally associated with the 'four As': disturbance of associations, affective disturbance, ambivalence and autism or withdrawal from shared reality?

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Correct answer: B — Eugen Bleuler

Eugen Bleuler introduced the term schizophrenia in 1908 and developed the concept in his 1911 monograph on the group of schizophrenias. His account is conventionally recalled through the four As: disturbance of associations, affective disturbance, ambivalence and autism. This mnemonic is useful for examinations but does not fully capture Bleuler's model, in which splitting of psychic functions was central. Kraepelin had earlier grouped related illnesses under dementia praecox. Kurt Schneider described first-rank symptoms, while Karl Jaspers made major contributions to phenomenology and the understanding of delusions. Freud influenced Bleuler's psychological thinking but neither introduced schizophrenia nor originated the four-As formulation.

Reference: Moskowitz A, Heim G. Eugen Bleuler's Dementia praecox or the group of schizophrenias (1911): a centenary appreciation and reconsideration. Schizophrenia Bulletin. 2011;37(3):471–479. https://pubmed.ncbi.nlm.nih.gov/21505113/